The Pharmaceutical Journal Vol 267 No 7172 p660
3 November 2001

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Give 'em pepper
Pyrotechnic pollution
Acting on impulse

Give 'em pepper

The frightful rise in the incidence of violence in modern society is rightly cause for deep concern. Much of it, I am sure, is the outcome of a culture of drug abuse, which is rooted in our way of life. This phenomenon, nevertheless, is as old as the hills, although it has changed shape in the course of human history.

Louis Lewin in his classic work 'Phantastica' (original German edition, 1924) commented in his introduction: "From the first beginning of our knowledge of man, we find him consuming substances of no nutritive value, but taken for the sole purpose of producing for a certain time a feeling of contentment, ease and comfort. Such a power was found in alcoholic beverages and in some vegetable substances, the same that are used for the purpose at the present day." Later in the book he gives a solemn warning: "Those who believe they can enter the temple of happiness through the gate of pleasure purchase their momentary delights at the cost of body and soul." In recent years we have gone beyond addictions to alcohol and herbal products and found far more potent and unpredictable means of escaping into the world of fantasy, provided for us by the chemical and pharmaceutical industries.

The problem of violence itself, whether stirred up by drugs or other means, has raised a host of practical problems for our police forces. The stupid and unnecessary commerce in firearms and replica firearms has resulted in regrettable habits like the shoot-to-kill policy, and chemical methods of temporarily disabling potentially violent people, using substances of doubtful legitimacy such as chlorobenzylidene malononitrile (CS gas). Chemical restraints are, I believe, of doubtful ethical justification, and need only the application of a heavy hand to render them lethal.

I often wonder whether a less harmful substance than CS gas might not be practicable. Some years ago, in a situation where physical assault on a dark night was a distinct possibility, I was advised by a sensible old landlord to carry a bag of pepper when I went out to work at night. Alternatively, he told me, a pocketful of fine sand was almost as effective a deterrent. These materials, flung in the face of an assailant, were guaranteed to confuse him and permit escape from the menace. Fortunately, I never had occasion to try either, but am inclined to believe him.

Of course, when a policeman is confronted with a violent customer, possibly armed with a handgun, distance becomes a controlling factor. Yet, surely such a disorientating material might be packaged in a projectile form, which does not call for close quarters. A little plastic bag of pepper fired from a tube might do a great deal to deter even a tough gunman, if it hit him on the face. It might blind him for a few hours, but is very unlikely to do any permanent damage. Modern technology could meet this challenge, could it not?

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Pyrotechnic pollution

Ozone as a secondary pollutant and greenhouse gas is formed from molecular oxygen by the action of sunlight and nitrogen oxides. A subtler source of ozone is described by a group of New Delhi scientists in Nature for 28 June. They were examining the effect on the atmosphere of the exuberant display of colourful sparklers used during the Diwali (Deepavali) festivities that take place every October or November in Delhi. Concentrations of nitrogen oxides, ozone and other gases were measured after an unprecedented quantity of fireworks had been set off in November 1999.

During the festival period the atmospheric ozone concentration reached a peak around noon and fell to negligible levels after sunset. No correlation was found between nitrogen oxides and ozone, which indicated that ambient nitrogen oxides were unlikely to have been concerned with ozone generation. However, there was a relation between inflammable material present in sparklers and cumulative ozone.

Sparklers depend for their colour and sparkle on potassium perchlorate, sulphur, strontium nitrate, barium nitrate, sodium oxalate, mercurous chloride, aluminium and manganese. A significant proportion of the light they emit is of a wavelength lower than 240nm. The energy emitted is sufficient to dissociate molecular oxygen to atomic oxygen in the atmosphere and enable the ozone reaction to occur. The process is therefore similar to that by which ozone is produced by ultraviolet irradiation.

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Acting on impulse

A recent addition to my vocabulary is the word "impulsivity", which I came across in a commentary in The Lancet for 22 September by two psychiatrists from the Mount Sinai School of Medicine in New York. According to the Oxford English Dictionary, impulsivity is "the character of acting on impulse without reflection or forethought".

The same authority informs me that the word was introduced by Cesare Lombroso, the celebrated physician, and expert in criminal anthropology, who flourished in Turin at the end of the 19th century. Lombroso wrote of the psychology peculiar to individuals suffering from epilepsy and remarked that marked impulsivity was a prominent factor in the suicidal behaviour of some adolescents.

Impulsivity is thus regarded as a dimension of personality which involves the inability to resist an impulse, drive or temptation that is harmful to oneself or one's neighbours. Those who suffer the stigma are impatient and unable to wait for due rewards, careless and risk-taking, seeking new sensations and pleasures, and oblivious to the harm involved in their activities. Among the manifestations of the syndrome are pathological gambling, pyromania, kleptomania and trichotillomania. Associated with these things are aggressive and antisocial behaviour, substance abuse and attention deficit hyperactivity disorder. This is a formidable background, throwing up a picture of someone none of us would care to meet on a dark night.

Lesions of the brain amygdala or frontal lobes have been found to be associated with this condition, and there appears to be a failure of serotonin regulation involved. Treatment with drugs affecting neurotransmission has been used to control it. Selective serotonin reuptake inhibitors have reduced impulsivity in pathological gambling, borderline personality disorder, sexual addictions and obsessive-compulsive disorders. Gamma-aminobutyric acid has decreased aggression in autism, and it seems that impulsivity is amenable to drugs that affect the serotonin, noradrenergic, dopaminergic and opioid systems.

According to The Lancet commentary, an ability to moderate pathological impulsivity is of great clinical and public health relevance "because impulsive disorders incur large costs to society, and are associated with substantial morbidity, mortality, social, family and job dysfunction, accidents, suicide, violence, aggression, criminality, and excessive use of health care, government and financial resources". Indeed, I imagine that the roads of Britain would become much safer if only we could curb impulsivity through some simple process. The murky world of politics, too, might conceivably take on a more civilised appearance.

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